There are many factors to consider when exploring what may be affecting your erection, and they often overlap. The good news is that cutting-edge technology, GAINSWave Acoustic Wave Therapy, is now available to treat the cause and not just the symptoms of ED. Instead of merely trying to undo the symptoms of ED, this procedure treats the root cause of the ED and enables patients to achieve and sustain firm erections.

EDGE chatted with Dr. Gary Guarnaccia, Manhattan Medical Associates' senior doctor, about specific contributing factors to ED, and how GAINSWave treatment can help. And the best part? GAINSWave doesn't use any needles or drugs. The procedure is non-invasive, non-surgical, and there are no side effects.

EDGE: What are some of the determining factors between erectile dysfunction and intermittent performance issues?

Dr. Guarnaccia: While most men will have occasional problems with erections, any condition where the problems become progressively worse or happen routinely during sex should be treated. One night where it takes more stimulation to get an erection or the erection does not come at all could be due to some temporary issues (alcohol, stress, etc.). But if this happens regularly, you should see a doctor.

EDGE: Can smoking or vaping effect erectile performance? If so, how?

Dr. Guarnaccia: Smoking and vaping release harmful chemicals into your body. These chemicals can damage the lining of the blood vessel walls and prevent them from functioning normally.

As blood vessels leading to the penis and in the penis can not dilate normally due to this damage, an erection may become harder to get or even physically impossible. Smoking has also been shown to decrease the amount of nitric oxide, a compound that the body uses to dilate blood vessels and initiate an erection. The research clearly shows that smoking increases the likelihood of erectile dysfunction at virtually any age. The U.S. Surgeon General has added erectile dysfunction to the list of side effects that can be caused by smoking.

EDGE: What are other lifestyle choices that can impact blood flow?

Dr. Guarnaccia: In general, men can assume that what is bad for your overall health, will be bad for your penis. So, for example, heavy drinking, drug use, ongoing stress and anxiety, obesity and other such problems will reduce testosterone levels, lower vascular nitric oxide production, and make erectile dysfunction more likely.

Also, any lifestyle choices that promote diabetes, high blood pressure, and cardiovascular disease will absolutely have a strong and direct correlation with erectile dysfunction.

EDGE: Do you recommend psychological support in addition to shock wave therapy?

Dr. Guarnaccia: Shockwave therapy has been very successful in treatment of erectile dysfunction. We find that psychological issues almost always follow physical problems when it comes to erections. But as the physical problems are resolved and men can have erections again, they usually regain their confidence.

Occasionally, however, erectile dysfunction can be indicative of much stronger psychological issues that often pre-date erection problems. In such instances, therapy is often helpful if not vital and we highly recommend seeking it.

EDGE: Do you see any shifting trends in the demographics of those seeking GAINSWave treatment?

Dr. Guarnaccia: The biggest trend we are seeing is that the GAINSWave treatment is becoming more and more popular given that it's the first and only FDA-cleared treatment that actually treats the cause of erectile dysfunction, not just the symptoms.

While men are still reluctant to talk about the condition and to seek help, more and more men are confronting the problem and seeking a cure. The other big trend that we are seeing is that this is no longer confined to men in their 50s, 60s and 70s. We are seeing a lot of men in their 30s and 40s seeking to address the issue or simply fix some performance issues.

EDGE: What if your erection is "good" but you want it to be "great" — is GAINSWave an option?

Dr. Guarnaccia: GAINSWave is becoming a very popular choice for men that are seeking to enhance their performance and take their erections from "good" to "great." As men age, erection quality declines. So even for men in their 30s and 40s, erections are not as great or as frequent as it was when they were younger. And the refractory period, the time between orgasm and the next erection, gets longer.

The GAINSWave treatment has been the best option by far to correct this. Even men without erectile dysfunction will find a significant increase in the quality of the erections, stronger orgasms, and a shorter refractory period after getting the GAINSWave treatment.

All content above was created and published for informational purposes only. It is not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice.

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Matthew Wexler is EDGE's National Senior Editor of Travel, Lifestyle, Health & Branded Content. More of his writing can be found at www.wexlerwrites.com. Follow him on Twitter and Instagram at @wexlerwrites.

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